How has Guinea learnt from the response to outbreaks? A learning health system analysis

Millimouno, Tamba Mina; Meessen, Bruno; Put, Willem van de; Garcia, Marlon; Camara, Bienvenu Salim; Christou, Aliki; Delvaux, Thérèse; Sidibé, Sidikiba; Béavogui, Abdoul Habib; Délamou, Alexandre

doi:10.1136/bmjgh-2022-010996

Cited by 6 publications

(14 citation statements)

References 130 publications

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“…Twenty papers included a definition of an LHS [2,31,37,38,40,41,44,46,48,52,54,[57][58][59][60][61][62][63][64][65] (Table 2). Twenty-seven unique references were used to cite these LHS definitions.…”

Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

“…Of 17 studies (53%) that reported use of an LHS framework, 11 used existing frameworks that were not explicitly modified from their original structure [37,38,40,41,43,46,48,51,56,57,62], 4 adapted an existing framework in response to the COVID-19 pandemic [44,49,59,64], and 2 developed new frameworks [52,54] (Table 2).…”

Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

“…Transparency around decision-making, data usage and management, or the involvement of AI, was discussed in eight papers (38%) [31,38,45,48,50,54,59,64]. Five papers (24%) discussed the need for incentives aligned to improve LHS processes [38,46,48,54,55], such as using performance indicators that measure the time from evidence release to clinical uptake [38]. Two papers (10%) raised concerns about the sustainability of the advances made by the LHS during the COVID-19 pandemic [2,62], due to limited funding or reimbursement.…”

Section: Incentivesmentioning

confidence: 99%

“…The Structure and Governance (n = 12, 41%) [37-41, 45, 46, 53, 55, 59, 64, 65] of the LHSs facilitated streamlining of ethics and research processes [38,41,45,64,65] and the ability to develop and deploy public health strategies [37,39,55,59]. It also enabled working groups that can be commissioned and decommissioned as the course of a pandemic changes [37,46,53].…”

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

“…However, pandemics also presented challenges to the development or advancement of an LHS (n = 22, 69%). The pace of the pandemic spread created the need for rapid changes to policies and procedures in limited time frames [37,38,46,57,58,61,64] and brought the added difficulty of managing diverse stakeholders (such as the coordinating local and national level resources). The existing Structure and Governance of some LHSs struggled to adjust rapidly to these demands (n = 13, 59%) [2,31,37,38,46,54,55,57,58,61,64].…”

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

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Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Smith,

Fisher,

Dharmayani

et al. 2024

BMC Med

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Background Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is translated into actionable knowledge. This rapid review sought to determine how these health systems have used LHS frameworks to both address the challenges posed by the COVID-19 pandemic and climate change, and to prepare for future disturbances, and thus transition towards the LHS2.0. Methods Three databases (Embase, Scopus, and PubMed) were searched for peer-reviewed literature published in English in the five years to March 2023. Publications were included if they described a real-world LHS’s response to one or more of the following: the COVID-19 pandemic, future pandemics, current climate events, future climate change events. Data were extracted and thematically analyzed using the five dimensions of the Institute of Medicine/Zurynski-Braithwaite’s LHS framework: Science and Informatics, Patient-Clinician Partnerships, Continuous Learning Culture, Incentives, and Structure and Governance. Results The search yielded 182 unique publications, four of which reported on LHSs and climate change. Backward citation tracking yielded 13 additional pandemic-related publications. None of the climate change-related papers met the inclusion criteria. Thirty-two publications were included after full-text review. Most were case studies (n = 12, 38%), narrative descriptions (n = 9, 28%) or empirical studies (n = 9, 28%). Science and Informatics (n = 31, 97%), Continuous Learning Culture (n = 26, 81%), Structure and Governance (n = 23, 72%) were the most frequently discussed LHS dimensions. Incentives (n = 21, 66%) and Patient-Clinician Partnerships (n = 18, 56%) received less attention. Twenty-nine papers (91%) discussed benefits or opportunities created by pandemics to furthering the development of an LHS, compared to 22 papers (69%) that discussed challenges. Conclusions An LHS 2.0 approach appears well-suited to responding to the rapidly changing and uncertain conditions of a pandemic, and, by extension, to preparing health systems for the effects of climate change. LHSs that embrace a continuous learning culture can inform patient care, public policy, and public messaging, and those that wisely use IT systems for decision-making can more readily enact surveillance systems for future pandemics and climate change-related events. Trial registration PROSPERO pre-registration: CRD42023408896.

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Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

Section: Incentivesmentioning

confidence: 99%

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

See 3 more Smart Citations

Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Smith,

Fisher,

Dharmayani

et al. 2024

BMC Med

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Translational success of fundamental virology: a VSV-vectored Ebola vaccine

Anderson,

Coller

2024

J Virol

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Ebola virus disease (EVD) caused by Ebola virus (EBOV) is a severe, often fatal, hemorrhagic disease. A critical component of the public health response to curb EVD epidemics is the use of a replication-competent, recombinant vesicular stomatitis virus (rVSV)-vectored Ebola vaccine, rVSVΔG-ZEBOV-GP (ERVEBO). In this Gem, we will discuss the past and ongoing development of rVSVΔG-ZEBOV-GP, highlighting the importance of basic science and the strength of public-private partnerships to translate fundamental virology into a licensed VSV-vectored Ebola vaccine.

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A learning health systems approach to scaling up an evidence-based intervention for integrated primary mental healthcare case finding and referral in South Africa

Janse van Rensburg,

Hongo,

Mthethwa

et al. 2024

BMJ Glob Health

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Despite progress in the development and evaluation of evidence-based primary mental health interventions in low-income and middle-income countries, implementation and scale-up efforts have had mixed results. Considerable gaps remain in the effective translation of research knowledge into routine health system practices, largely due to real-world contextual constraints on implementation and scale-up efforts. The Southern African Research Consortium for Mental Health Integration (S-MhINT) programme used implementation research to strengthen the implementation of an evidence-based integrated collaborative depression care model for primary healthcare (PHC) services in South Africa. To facilitate the scale-up of this model from a testing site to the whole province of KwaZulu-Natal, a capacity building programme was embedded within the Alliance for Health Policy and Systems Research (AHPSR) learning health systems (LHS) approach. The paper discusses efforts to scale up and embed case finding and referral elements of the S-MhINT package within routine PHC. Data from semistructured interviews, a focus group discussion, proceedings from participatory workshops and outputs from the application of continuous quality improvement (CQI) cycles were thematically analysed using the AHPSR LHS framework. Learning particularly occurred through information sharing at routine participatory workshops, which also offered mutual deliberation following periods of applying CQI tools to emergent problems. Individual-level, single-loop learning seemed to be particularly observable elements of the AHPSR LHS framework. Ultimately, our experience suggests that successful scale-up requires strong and sustained relationships between researchers, policy-makers and implementers, investments into learning platforms and organisational participation across all levels to ensure ownership and acceptance of learning processes.

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How has Guinea learnt from the response to outbreaks? A learning health system analysis

Cited by 6 publications

References 130 publications

Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Translational success of fundamental virology: a VSV-vectored Ebola vaccine

A learning health systems approach to scaling up an evidence-based intervention for integrated primary mental healthcare case finding and referral in South Africa

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